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Thinking About Institutions: Milieux and Madness

Author(s) : R.D. Hinshelwood

Reviews and Endorsements

The interplay between the internal world of individuals and the external, social world has been the theme of many papers R.D. Hinshelwood has published over the past two decades. In this book he brings these ideas together, and shows how they derive from therapeutic community practice, and have arisen from a psychoanalytic understanding of the human unconscious. Many institutional phenomena derive from this hidden level, and have implications for therapeutic work in communities and in psychiatry, for understanding institutions in general, and for reflecting on public and political aspects of society at large. These themes link discussions of communication phenomena, of thinking and action in institutions, of alienation, and of the place of therapeutic communities in a psychiatric service.

Thinking About Institutions not only documents how a therapeutic community functions, it also contributes to understanding how people can be influenced by their social setting and how individuals can form coherent social organizations together.

'In this book, Bob Hinshelwood distils a lifetime of clinical and intellectual work to discuss the major contours of the social and psychological processes that can be found in the twentieth and twenty-first centuries. Using ideas drawn from the psychoanalytic world he examines the powerful relations that develop between groups and between individuals and their social surroundings. The argument is clearly and securely based, and will prove an enduring and helpful contribution to that spirit of reflective enquiry to which he is so deeply committed.'
- Nick Manning

Contents:
Introduction. Foreword by Nick Manning. Prologue: Demoralisation in the Hospital Community. PART ONE: BOUNDARIES AND BOUNDARY PHENOMENA. 1. Reversing the Old. 2. The Anxious Institution and its Defensiveness. 3. Role Relations and Power Relations. 4. The Community Personality: Complicity and Dramatisation. 5. Communication: Linking and Thinking. 6. Challenge and Paradox. PART TWO: ACTING AND THINKING. 7. The Institution's Primal Scene. 8. The Institution's Therapeutic Process. 9. Abuse and Acting-Out. 10. The Group as a Containing Reflective Space. 11. Reflection and Action. PART THREE: RELATIONAL NETWORKS. 12. A Group as Network. 13. The Supervision Network. 14. Chains of Links. PART FOUR: THE ALIENATED COMMODITY AND MARKET PSYCHOLOGY. 15. Alienation and Its Assumptions. 16. Health Capital. 17. Future Visions: Towards Community Care. Epilogue: Living Together. References. Index.